methyl b12 dosing for peripheral neuropathy
 

Hi.

I'm sure this question has been asked/addressed numerous times on here, but is there a "standard" dosing amount for methyl b12 for peripheral neuropathy? One other thing, I had my b12 level checked a year ago and it was 530 something if I recall.

Seems like I've read some conflicting things on this question, in terms of whether it's advised to do 1000mcg daily or 5000mcg daily?

Thanks.

530 is rather borderline. So I'd do 5mg of methylB12 daily on an empty stomach for 3 months. Then get checked again.

If you are over 1000 then you can cut back to 1mg a day.
At 1mg a day you absorb about 13mcg passively from that dose.
Enough to keep going, but not really high enough to fix things
that may be running poorly. B12 gets stored in the liver and crosses into the cerebral spinal fluid quite a bit, so when you are really low then those areas can take up alot of each dose. Once you hit a steady state there and in the tissues, then you can maintain
at lower dosing. But basically 5mg is not a whole lot daily either, and since B12 is rather benign it won't be harmful to continue with it at that level either. That part is up to you.

Thanks, mrsD. I believe it is your belief that the oral is just as good to take as the sublingual, or am I incorrect in that?

Ooops. Sorry, I see that this was all addressed in the sticky at the top of the page.

Yes. Even studies show that they give the same results on testing.

I really think the sublinguals are swallowed in the saliva.
But for those who "believe" they work, those individuals should
do so under the tongue on an empty stomach (just to be sure).

The B12 molecule is huge, and not lipophilic and not likely to
cross the small area under the tongue reliably IMO.

Daily oral use is closest to nature too. We were not evolved to
get mega shots every month. But to eat animal derived foods on a regular basis. The study I have linked to in the B12 thread here even shows that the injections only provide about 150mcg per 1000 shot anyway. One would think more but I guess it is excreted as a huge mega dose quickly. I read once within 72 hours. That is why people show up online with injection roller coaster side effects...up and down, feeling great feeling terrible the next day, etc.

Just went to the shop and picked some up (Jarrow's 5000mcg). MrsD, this is going to be a dumb question, but I just chewed it up and swallowed it...I assume this is the way to take it orally as opposed to swallowing the pill whole with water?

Thanks, just want to make sure I'm taking this right.

Yep, I chew them up too. No food for at least an hour after, to assure best absorption.

It is amazing how important this is, and we are so fortunate to have OTC access without inflated prices! So much for so little!;)

Slightly off topic, although fully about B12 and injections. I used to frequent a Dutch forum that is purely about B12. On that forum, injections are the "bees knees" and oral is frowned upon. On this forum, it is the opposite.

That was a bit puzzling to me, to say the least. However, I think there is an explanation.

1) Product used: on the Dutch forum, they absolutely advise against cyanocobalamin - much like here. The only injections they support are hydroxocobalamin. They go as far as saying that cyanocobalamin is next to useless. For people with metabolizing problems they do advise methylcobalamin injections, but they are not easy to come by. (a couple of users sourced them from Italy IIRC)

2) Schedule: again on the Dutch forum, the preferred treatment is to start with 5 (1000mcg) injections in 10 days, then move to 2 injections a week for a month, then go to weekly, and then go to monthly injections depending on how the patient feels. Note that we are still talking about hydroxocobalamin.

If I'm not mistaken, the major beef with injections on this forum is that cyanocobalamin ones have been seen to be ineffectif and that the serum levels might swing too much when you only follow a monthly schedule.

Would people (MrsD.) here see the value of their method of choice?

Mind you, I'm not trying to say who's right/wrong. Personally, I much prefer the daily oral version as the injections are cumbersome. I'm just trying to find a logical reason as to why there is such a big difference.

PS: please feel free to move this post/discussion to the B12 thread if that's a more appropriate place. :)

If people want to do invasive injections that is their choice.

But why do that when oral will give the same results?
(when done with methyl form and correctly on an empty stomach).

The problem I have is that monthly injection. It seems that it may not provide enough for everyone equally.

I will also add... frequent injections (like some weight loss doctors do for celebrities) may damage tissue over time.
I recall the autopsy report of Anna Nicole Smith, who had severe scarring and fibrosis in her buttocks from frequent B12 injections.
They also found several bottles of 30ml B12 in her fridge. (forensics). I followed that case and her son's death previously closely because it seemed that both of them were drug related.

So what matters is to get tested periodically and see what your levels become with what you are doing.

Some people can do cyano fine. Others not. So with the low price and easy availability of methyl oral now, why do anything else? I try and find the most economical (this is for life for most people), non invasive non side effect methods to fix your issues adequately. Ego does not really enter into it...and online there tends to be a trend to push the "best" method. And for people, this may vary depending on personal genetics and other factors.

There is a huge placebo effect for all medications, and for some that might include a spiffy injection. Up to 70% of results can be due to belief! Also in Europe the European Union has blocked some OTC
medications, and injections would still be available by the doctors
there who may want control of this issue. Methyl B12 here is typically
obtained by injection from compounding pharmacies.

Oh it is invasive alright! Sometimes, depending on who's giving the shot, it can be pretty painful as well. Combine a nurse/doc without a lot of patience, and B12 right from the fridge... ouch.

No discussion whatsoever.

Yeah, I was thinking about that when I wrote that I was feeling better a week or so ago. It's a huge effect indeed, and it's still being studied.

Well, the rules are a bit funky to be honest. For a 1000mcg injection, you need a prescription. However, for a 10,000mcg injection, you can get it OTC. Don't ask me why, nobody here was ever able to explain it to me.

FWIW, most docs here have not heard about hydroxocobalamin, let alone methylcobalamin. There's also a big difference between EU countries.

Also, my pharmacy drew a blank when I asked for some epsom salt. Even when I said "magnesium sulfate" there was just some head shaking.

Oh, my ... all pharmacies carry epsom salts... Usually they are on the bottom shelf in the first aid/band-aid section.

I get mine at Costco, in large resealable bags for savings.

But if they can't find them in your store, they may be out of stock, or if that inadequate, you need to find another retail outlet. Even Kroger's here has epsom salts. Sometimes they are in a carton that looks like a milk carton, but the trend today
is to have them in airtight resealable baggies.

When I was working I only recall twice getting an RX for hydroxocobalamin. (it was called hydroxycobalamin at one time).

It is used in ERs for cyanide poisoning and also for some smoke inhalation poisoning to remove cyanide from the body.

You can buy cyanocobalamin injectable on Ebay without an RX.
http://www.ebay.com/itm/Vitamin-B12-...item20cf77972a
In fact this label looks like the one Anna Nicole Smith had in her
fridge photos.
Some people do inject it subcutaneously now, but I think injections are just a waste for the most part. You can buy insulin syringes OTC too. Within the past 5 or 6 yrs the studies on oral use really match the injectable when tests are done over time.

Historically in the US giving B12 injections was a FAD, a trick doctors used when people complained about being "tired all the time". Then the insurances got after them, and the AMA sent out recommendations that it was no longer ethical to give
B12 willy nilly etc without a good reason. So the backlash was substantial...since they taught this new rule in medical schools, so now it is not common for doctors here to even give the shots anymore. In long term care however, B12 is very commonly given to patients in nursing homes. We got the testing requests, and the bolus one shot a day orders, and then the typical twice a month or monthly thereafter. Many elderly do well on B12.

Yes to epsom salts. They are found exactly where you said mrsD and in bags or the milk carton look alike as you said. I can't believe that those at the pharmacy had never heard of it. :(

It's a cultural thing really. We don't even have a word for it. "Bath salt" is the closest you'd get, but it is not recommended to try to order that these days. :wink: So no, it wasn't an "out of stock" situation. They even called the lady who makes the compoundings over there, and she had never heard of such a thing.

Of course there's always Amazon (in my case), but it seemed a waste to order such a cheap/heavy item, hence why I asked locally.

MrsD, the fad thing makes sense (sadly). B12 is very big in the buidy builder community as well.

Anyway, I won't complain if I never have to get those injections again. I'm curious to see my next test results after 3 months of Jarrows 5mg.

I looked up some European names for you...since you are not in US?

1) in Belgium : "Sels anglais"

2) in France: "sels d'epsom"

3) English: magnesium sulfate

4) German: Magnesium sulfat or Bittersalz ...some mention by internet of purchasing here:" I know the Apotheke will have it"-

It appears that this is a cultural thing. I found some people on the net importing theirs to Europe from Vitacost!